With an aging baby boomer population and the implementation of the Affordable Care Act, more individuals than ever before are seeking the services of healthcare providers.
The US Bureau of Labor Statistics reports that occupations and industries related to the field of healthcare are projected to add the most new jobs by 2022. Without a doubt, the need for healthcare providers is growing at an unprecedented rate. The American Association of Medical Colleges predicts a deficit of 46,000 to 90,000 physicians by 2025. And the American Association of Colleges of Nursing projects a growing shortage of nurses, with experts predicting the need for over 1 million new nurses by 2022.
Clearly, supply is not meeting the demand for skilled healthcare professionals. For this reason, a top priority for healthcare organizations has to be the attraction and retention of their employees. In such a competitive environment, how does management at hospitals and other health facilities draw in skilled professionals?
Healthcare Turnover Rates
Employee retention is key to the overall and fiscal health of any organization. Staff turnover is estimated to account for up to 5-5.8 percent of total hospital annual operating budget.
In addition to the costs associated with replacing employees, low turnover improves quality and continuity of care for patients. Physicians practice more efficiently and are better engaged when facilities are able to maintain a highly competent workforce.
A healthcare facility’s bottom line is affected when employees must deal with constant orientation of new staff or working short when staff replacements are not found. These issues impact morale, attendance, and satisfaction.
As the economy has grown since the recession in 2008 and as the unemployment rate continues to slowly drop, turnover rates are on the rise. Employees may leave a current position for a promotion, better opportunity for advancement, better compensation, or workplace frustrations and burnout. According to Compdata Surveys’ national survey of healthcare staff ranging from entry-level to top executives at 10,250 healthcare facilities, the average total turnover rate reported for healthcare employers in 2015 was 19.2 percent, up from 17.7 percent the previous year.
Voluntary turnover rates have also increased and vary by facility type. Long-term care facilities had the highest voluntary turnover rate at 19 percent while medical groups reported the lowest at 10.3 percent.
A 2017 survey report from Leaders for Today identified that healthcare facilities are facing higher turnover and attrition rates than in the past. It’s affecting every role, from the top senior executives to the front desk and the front lines. Data revealed hospitals will need to replace virtually half of their staff every five years. Nearly 43 percent of respondents reported they have been with their current hospital for fewer than two years and 65.7 percent said they have been with their hospital for fewer than five years.
The survey found 37 percent of respondents planned to leave their current organization within the next two years and 68.6 percent planned to leave within five years. There is also a shrinking talent pool as more hospital employees retire, with 47.7 percent of survey respondents expecting to retire within the next decade.
Nursing Turnover Rates
In the coming years, the U.S. will see an increased demand for healthcare services due to an aging population, longer life expectancies and growing rates of chronic conditions. Nurses comprise the largest segment of healthcare professionals.
Nurse turnover is expensive and disruptive, and it jeopardizes patient safety and quality of care. Turnover rates are highest when jobs are abundant and nurses who are dissatisfied with their current position have numerous other options. As the nurse workforce ages, facilities are looking at a significantly smaller pool of experienced talent to fill open positions.
Early-career nurses will be needed to fill the void left by retiring baby-boomers. Turnover tends to be highest during the early years of a nurse's career. A study by Kovner and colleagues found the one-year turnover rate among all newly licensed RNs was 17.5 percent and the two-year turnover rate was 33.5 percent.
While some degree of employee turnover is expected and healthy, workplace dynamics that drive increased employee turnover rates can often be modified. Managers can keep high-performing employees happy and engaged so that the continuity and performance of the system remains intact.
As Compdata Surveys Vice President, Amy Kaminski states: “Employers are reporting rising voluntary turnover rates, indicating the workforce has increasing confidence in the job market. Your key employees have options when it comes to where they want to work. Understanding turnover trends allows you to put programs into place for retaining your quality employees, [and] develop a solid plan for recruiting new ones.”
Hospitals across the country use benchmarking to determine the top priorities for improvement. The benchmarking process allows hospital executives to see how their organizations compare to competitors. Healthcare turnover benchmarks can be met if organizations take the following measures to retain highly qualified individuals over long-term employment periods:
- Optimize the hiring process and act quickly so top candidates aren’t lost as they accept opportunities elsewhere.
- Implement peer interviewing to ensure each new hire is a fit for the organization. The candidate can meet future coworkers and employees can determine if there's a cultural fit and have final say in who is hired.
- Assimilate and acculturate new employees to the required professional skills and expected normative group behaviors at the time of hire.
- Implement nurse residency programs for newly licensed nurses. These programs have been shown to reduce turnover and to be more cost effective than traditional orientation programs.
- Create a supportive environment to improve the perception of organizational support, employee engagement, team cohesion, and connection to the organization’s mission.
- Assess employee engagement and identify any problems that might lead to disengagement through weekly rounding on units and organized surveys. Develop impact plans based on results to improve identified areas of engagement.
- Focus on high performers. Management can informally recognize high performers and encourage their development in an effort to "re-recruit" them to the organization.
- Place low job performers on an improvement plan that specifically identifies what they need to change by a specified date.
Five Tips to Retain Healthcare Staff
According to Healthcare Dive, there are several approaches organizations have taken to attract top employees. Here are five that are relatively easy to implement.
1. Flexible scheduling
Patient needs come first, but healthcare organizations are seeing the value of offering employees flexible shifts and accommodating preferences for evening versus day, and weekday versus weekend hours.
2. Professional development
Opportunities for career growth consistently rate high among employees. Many healthcare organizations offer benefits such as tuition reimbursement and on-the-job training sessions.
3. Generous benefit package
Beyond providing competitive wages, and healthcare and retirement benefits, many companies attract employees by offering free or very-reduced cost childcare, bonuses and unlimited sick time.
4. Social media
The younger generations have the most years remaining as part of the workforce. Organizations are reaching out through technology and social media to attract and retain the most energetic members of society.
5. Holding on to the best
Keeping great employees around is just as important as hiring the right staff. Experts agree that the best thing management can do for employees is to keep them happy by listening to concerns and considering solutions from every staff member, at all levels. Companies that consider their staff to be their biggest asset are the same companies that tend to hold on to, and draw in, the most talented employees.
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